How is Chronic Myelomonocytic Leukemia Diagnosed?

Chronic myelomonocytic leukemia (CMML) is diagnosed through a series of tests that examine the blood and bone marrow. The process usually begins with a physical examination where the doctor checks for physical signs of CMML such as fatigue, weight loss, frequent infections, pale skin and enlargement of the liver and spleen. If CMML is suspected, the following tests may be conducted:

Blood Tests:

• Complete blood count (CBC): This test measures the amount of different types of cells in the blood. In CMML, there may be an increase in the number of monocytes, a type of white blood cell and a decrease in other types of blood cells like red blood cells and platelets.
• Peripheral blood smear: In this test, a sample of the patient's blood is examined under a microscope to check for abnormal cells. 
• Lactate dehydrogenase (LDH): LDH is an enzyme released from damaged or rapidly dividing cells. Elevated LDH levels may be observed in the blood.
• Erythrocyte sedimentation rate (ESR): An increased ESR may be seen, indicating inflammation or infection.

Bone Marrow Tests:

• Bone marrow aspiration and biopsy: These tests involve taking a small amount of bone marrow from the hipbone or breastbone and examining it under a microscope. The presence of increased monocytes in the bone marrow is a characteristic finding in CMML.
• Flow cytometry: This test is used to measure the number of cells in a sample of bone marrow, as well as their size, shape, and the presence of certain markers on the cell surface. It can help diagnose CMML.
• Cytogenetic Analysis: This test may reveal specific genetic abnormalities, including chromosomal rearrangements or mutations. The presence of certain genetic markers, such as the presence of the Philadelphia chromosome (Ph), can also provide diagnostic information.

Imaging Tests:

• Chest X-ray: This test can help determine if the disease has spread to the lungs.
• Computed Tomography (CT) scan: A CT scan can provide detailed images of the inside of the body and can help determine if the disease has spread to other organs.

A Summary of Diagnosing Chronic Myelomonocytic Leukemia

It's important to note that the diagnosis and classification of CMML is complex and requires a comprehensive evaluation by a team of specialists. A complete diagnosis requires a physical examination, looking at a bone marrow sample under the microscope and genetic testing. The specific markers and genetic changes found in the bone marrow sample can also help determine a person's prognosis and guide treatment decisions. If you don't currently have a CMML specialist on your team, it is important that you consult with one. Use HealthTree's CMML Specialist Directory to locate a specialist near you. 

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